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General NPI Number Information
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NPI Number | 1831711894
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Entity Type | Individual
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Provider Name | PORTIA BROWN
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Gender | Female
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 550 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 646-929-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 3128 HENRY HUDSON PKWY APT 502
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City | BRONX
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State | NY
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Zip | 10463-3296
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Country | US
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Telephone | 201-417-7676
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 702004
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 431712
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 431712
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License Number State | NY
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